| NPI | 1770859944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME140000) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: FL ME140000) |
| 2086X0206X Surgery, Surgical Oncology (Licence: FL ME140000) | |
| Enumeration Date | 2012-03-31 |
| Last Update Date | 2025-01-08 |